title: Bigger chairs at smaller tables.
abstract: As noted in the commentary by Kastor, chairs of academic clinical departments in medical schools now find themselves beleaguered by issues and responsibilities-and in reporting relationships-that are beyond the traditional scope of those positions. The situation is particularly acute in departments of medicine. This commentary suggests that departments of medicine have become too large and that chairs are no longer able to focus on the more traditional missions of the department of medicine, most notably direct clinical care and teaching. An argument is made for limiting the scope of departments' clinical and research programs, thereby enabling academic chairs to regain the level of prominence and satisfaction that has traditionally been associated with those distinguished positions.
authors.affiliation: Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA, USA. Jack.Ende@uphs.upenn.edu
authors.forename: Jack
authors.initials: J
authors.lastname: Ende
mesh_terms: D006785:Hospitals, University / Q000458:organization & administration*; D006801:Humans; D007587:Job Description; D007857:Leadership; D010560:Personnel Selection